Characteristics and outcomes associated with the use of dexamethasone, remdesivir and tocilizumab in acute care patients during wave 2* of the COVID-19 pandemic
| Characteristic | Dexamethasone n = 631 | Remdesivir n = 631 | Tocilizumab n = 631 | ||||||
|---|---|---|---|---|---|---|---|---|---|
| No | Yes | RR or MD (95% CI)† | No | Yes | RR or MD (95% CI)† | No | Yes | RR or MD (95% CI)† | |
| No. (%) of patients | 180 (28.5) | 451 (71.5) | – | 532 (84.3) | 99 (15.7) | – | 607 (96.2) | 24 (3.8) | – |
| Characteristics | |||||||||
| Age, median (IQR) | 79.0 (71.0–86.0) | 80.0 (72.0–88.0) | – | 81.0 (72.0–88.0) | 75.0 (69.5–84.5) | – | 80.0 (72.0–88.0) | 73.5 (70.0–81.0) | – |
| Female, no. (%) | 98 (54.4) | 193 (42.8) | – | 253 (47.6) | 38 (38.4) | – | 281 (46.3) | 10 (41.7) | – |
| Frailty, no. (%)‡ | 104 (57.8) | 274 (60.8) | – | 339 (63.7) | 39 (39.4) | – | 371 (61.1) | 7 (29.2) | – |
| Dementia, no. (%) | 42 (23.3) | 106 (23.5) | – | 137 (25.8) | 11 (11.1) | – | 147 (24.2) | 1 (4.2) | – |
| Chest x-ray infiltrates, no. (%) | 87 (48.3) | 354 (78.5) | – | 361 (67.9) | 80 (80.8) | – | 425 (70.0) | 16 (66.7) | – |
| Fever, no. (%) | 60 (33.3) | 239 (53.0) | – | 242 (45.5) | 57 (57.6) | – | 281 (46.3) | 18 (75.0) | – |
| C-reactive protein, mg/dL, median (IQR) | 30.5 (11.0–53.2) | 88.6 (49.4–157.5) | – | 71.6 (31.1–134.1) | 65.0 (48.0–134.0) | – | 62.0 (33.0–127.0) | 148.7 (88.2–183.9) | – |
| Outcomes | |||||||||
| In-hospital death, no. (%) | 13 (7.2) | 168 (37.3) | 1.46 (1.35–1.59) | 155 (29.1) | 26 (26.3) | 0.88 (0.58–1.33) | 172 (28.3) | 9 (37.5) | 1.48 (0.66–3.32) |
| Length of stay, d, median (IQR) | 7.0 (3.0–14.0) | 11.0 (7.0–21.0) | 4.0 (2.0–5.0) | 10.0 (5.0–19.0) | 11.0 (7.0–22.0) | 1.0 (0–3.0) | 10.0 (6.0–19.0) | 14.0 (7.8–20.0) | 2.0 (−2.0 to 6.0) |
| Delirium prevalence, no. (%) | 66 (36.7) | 266 (59.0) | 1.29 (1.16–1.43) | 287 (53.9) | 45 (45.5) | 0.75 (0.52–1.08) | 316 (52.1) | 16 (66.7) | 1.80 (0.78–4.13) |
| Delirium incidence, no. (%)§ | 29/136 (21.3) | 103/277 (37.2) | 1.26 (1.11–1.43) | 109/338 (32.2) | 23/75 (30.7) | 0.94 (0.60–1.47) | 125/399 (31.3) | 7/14 (50.0) | 2.13 (0.76–5.95) |
| ICU admission, no. (%) | 20 (11.1) | 128 (28.4) | 1.30 (1.19–1.42) | 128 (24.1) | 20 (20.2) | 0.82 (0.52–1.29) | 134 (22.1) | 14 (58.3) | 4.54 (2.06–10.01) |
| Complications | |||||||||
| Use of restraints, no. (%) | 17 (9.4) | 109 (24.2) | 1.27 (1.16–1.40) | 105 (19.7) | 21 (21.2) | 1.08 (0.69–1.67) | 120 (19.8) | 6 (25.0) | 1.33 (0.54–3.29) |
| Falls, no. (%) | 12 (6.7) | 22 (4.9) | 0.90 (0.70–1.16) | 31 (5.8) | 3 (3.0) | 0.55 (0.18–1.64) | 33 (5.4) | 1 (4.2) | 0.76 (0.11–5.48) |
| Respiratory failure, no. (%) | 7 (3.9) | 104 (23.1) | 1.40 (1.30–1.51) | 93 (17.5) | 18 (18.2) | 1.04 (0.65–1.66) | 104 (17.1) | 7 (29.2) | 1.93 (0.82–4.53) |
| Acute respiratory distress syndrome, no. (%) | 2 (1.1) | 74 (16.4) | 1.43 (1.34–1.53) | 63 (11.8) | 13 (13.1) | 1.10 (0.65–1.88) | 70 (11.5) | 6 (25.0) | 2.43 (1.00–5.93) |
Note: CI = confidence interval, ICU = intensive care unit, IQR = interquartile range, MD = mean difference, RR = relative risk.
↵* Aug. 1, 2020, to Feb. 20, 2021.
↵† Where appropriate.
↵‡ Defined as a score on the Clinical Frailty Scale ≥ 5.
↵§ Calculated by excluding those who presented with delirium, so the base population size was different for this row.